摘要
目的探讨卵巢上皮性癌（卵巢癌）患者化疗后肿瘤标志物谱的变化及其潜在的临床意义。方法选择1999年1月至2007年7月期间经肿瘤细胞减灭术及规范化疗的卵巢癌患者102例，对其术前、术后、每次化疗前、随访期间和复发前后的血清肿瘤标志物CA125、CA19-9和CP2的水平进行检测、分析，其中48例患者的肿瘤标志物记录完整而纳人分析，复发患者为28例，初治化疗患者20例（均为耐药病例）。根据肿瘤标志物谱变化与否，分别将复发和初治化疗患者分为肿瘤标志物谱变化组与未变化组。平均随访时间为25个月。结果（1）肿瘤标志物谱的主要变化表现为标志物的数量变化和（或）标志物的种类改变。28例复发患者中肿瘤标志物谱发生变化者占46％（13／28），20例初治化疗患者中标志物谱发生变化者占45％（9／20）。（2）肿瘤标志物谱变化的复发患者中，病理类型以浆液性癌所占比例最高，为77％（10／13），而初治化疗患者中，以黏液性癌所占比例最高，为4／9。（3）复发患者肿瘤标志物谱变化组的无疾病进展期和中位总生存时间分别为22．2、60．0个月，较未变化组（分别为17．4、46．0个月）明显延长（P均〈0．05）；初治化疗患者肿瘤标志物谱变化组的中位总生存时间较未变化组（分别为15．9、25．0个月）明显缩短（P〈0．05）。结论卵巢癌化疗期间和复发后肿瘤标志物谱可发生变化，化疗及随访期间应对肿瘤标志物进行联合检测。
Objective To investigate whether the change of serum tumor markers profile after chemotherapy in epithelial ovarian carcinoma and evaluate the clinical significance. Methods The levels of CA125, CA19.9 and CP2 before and after initial surgery, during primary chemotherapy and follow-up were serially measured and analyzed retrospectively in 28 cases of recurrent epithelial ovarian carcinoma patients and 20 cases of primary chemo-resistant ovarian carcinoma patients from Jan 1999 to July 2007. According to whether the change of serum tumor markers profile, all the patients were divided into two groups： marker changed-group and marker un-changed group. The average follow up period was 25 months. Results （ 1 ） The changes of tumor marker profile were included the number and （or） types of markers, which included 13 cases （46% , 13/28） of the recurred cases and 9 cases （45%, 9/20） of the primary chemo-resistant cases. （2） For recurrent ovarian carcinoma changed tumor marker profile, the highest pathology type was serous histological type （77% , 10/13 ）, while was mucinous histological type （4/9） for primary chemoresistant patients. （3） For recurred patients, the median progression-free survival （PFS） and median overall survival （OS） in marker changed-group （22. 2 and 60.0 months） were significantly longer than that in marker un-changed group （ 17. 4, 46. 0 months; P 〈 0. 05 ） . For primary chemo-resistant ovarian carcinoma patients, median OS in marker changed-group （15.9 months） was significantly shorter than that in marker un-changed group （25.0 months ; P 〈 0. 05 ）. Conclusion The profile of serum tumor makers in epithelial ovarian carcinoma may be changed after chemotherapy, which should be concomitantly determinate different serum tumor markers for monitoring the response to chemotherapy and follow-up of patients.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2009年第2期121-125,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
卵巢肿瘤
肿瘤标记
生物学
药物疗法
Ovarian neoplasms
Tumor markers, biological
Drug therapy
